Skrotal mezenterik kist olgusu

Mesenteric cysts are rarely seen intraabdominal mass lesions which can manifest themselves with different clinical signs, and symptoms. They can locate in the mesenterium from duodenum down to rectum, and also in the retroperitoneal space. Herein we present a very rare case of a scrotal mesenteric cyst which resembled an epididymal cyst in a 6-year-old boy. Ultrasonographic examination revealed a multiloculated cyst completely filling the scrotal sac, and the cyst was excised surgically. Histopathological examination described the surgical specimen as chylolymphatic mesenteric cyst, and during one year follow-up any recurrence was not observed

Laparoscopic adrenalectomy: Our clinical experiences with the first 10 patients

Objectives: The aim of this study is to present the resultsof our first ten laparoscopic adrenalectomy cases whichwere performed in our clinic.Materials and methods: Between December 2010 andSeptember 2012 the standard transperitoneal laparoscopicadrenalectomy was performed on 10 patients.Data of patients such as age, weight, height, operationtime, hospitalization time, complications, size of adrenalmass and pathological diagnosis were retrospectively reviewedand recorded from the hospital records.Results: Three of ten patients were male and seven ofthem were female. The mean age of the patients was42.12±11.4 (21-55) years. Mean operation time was recordedas 136±23.6 (100-190) min. Mean tumor size was7.1±2.7 (5-12) cm. None of the patients required bloodtransfusion. Mean hospital stay was 2.3±1.2 (2-6) days.Pathological diagnoses of masses were pheocromacytomain two patients, adrenal adenoma in six, myelolipomain one and pseudocist in one.Conclusions: According to our experience with the limitednumber of the first ten cases, transperitoneal laparoscopicadrenalectomy is a safe and effective treatmentmodality, associated with minimal morbidity. To obtainmore reliable information larger series with long-term resultsof laparoscopic adrenalectomy is needed.Key words: Laparoscopy, adrenalectomy, experience,transperitonea

Our experiences on retrograde intrarenal surgery

Objective: To evaluate outcomes of the cases who had undergone retrograde intrarenal surgery (RIRS) in our clinics. Methods: Outcomes of 100 cases who had undergone RIRS because of renal stones between February 2012, and May 2013 were retrospectively evaluated. Results: Study population consisted of 35 female and 65 male patients with a mean age of 36.81(1-76) years. RIRS was performed with the indication of rest double J (D-J) stent (n=1), and renal stone (n=99). Mean stone size was 15.26 (5-27) mm. Preoperatively, 61 cases (61%) had preexisting D-J stents, while 39 (39%) cases were stentless. Access sheaths were used in 86 (86%) cases, while in 14 (14%) cases the procedure was applied without using an access sheath. Mean operative, and fluoroscopy times were 52.72 (10-120) minus, and 57.32 (10-180) seconds, respectively. Postoperatively D-J stents were implanted in 88 (88%) cases, and 12 (12%) cases were stent-free. Mean hospital time was 1.3 (1-7) days. After one month postoperatively, stone-free rate was achieved in 87 (87%) patients. Clinically insignificant residual stone fragments (CIRF) 6 (6%), and residual stones 7 (7%) were also detected. The latter group consisted of cases with horseshoe kidney (n=1), pelvic kidney (n=1), and kyphoscoliosis (n=1). Also in two case procedure was terminated prematurely, because of blurring of the vision secondary to bleeding. Apart from these patients, any preoperative complication did not develop. During follow-up period, urinary tract infection developed in 3 patients with resultant renal parenchymal damage in one patient. In one patient, D-J stent migrated into ureter. Conclusion: Retrograde intrarenal surgery is an effective and safe technique in the management of renal stones

long term results of the tension free vaginal tape and fascial sling in treatment with stress urinary incontinence

Amaç: İdrar inontinans tedavisinde uygulanan fasyal sling ve transvaginal tape (TVT) operasyonlarının sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya Mayıs 2002- Temmuz 2008 tarihleri arasında inkontinansları fasyal sling ve TVT ile tedavi edilen 113 kadın hasta dahil edildi. Postoperatif ped kullanmama ve tam kuruluk hali başarı olarak kabul edildi. Ped sayısında %50 azalma kısmi başarı, ped sayısında %50’den az azalma başarısızlık olarak kabul edildi. İstatistiksel analizde student t test ve ki-kare testi kullanıldı ve SPSS®18.0 paket programı ile yapıldı. p<0.05 istatistiksel olarak anlamlı olarak kabul edildi. Bulgular: Yaş ortalaması 52.94 (31-78), takip süresi TVT için 44.3±8.7 ay, fasyal sling için ise 74.7±12.4 idi. Hastaların %79.5’inde mikst tip inkontinans mevcuttu. Her iki grupta hastaların inkontinans tipi, inkontinans şiddeti ve yaş dağı- lımları benzerdi (p>0.05). Başarı oranları TVT grubunda %96 ve fasyal sling grubunda %77 olarak saptandı (p<0.001). TVT yapılan hastalarda kanama daha az saptandı, operasyon süresinin ve hastanede kalış süresinin daha kısa saptandı ve bu bulgular istatistiksel olarak anlamlı idi (p<0.05). Obstruktif bulgular ve postmiksiyonel rezidüel idrar oranları fasyal sling grubunda daha fazla olarak saptandı (p<0.05). Her iki grupta da mesane perforasyon oranlarına birbirine yakın saptandı (p>0.005) ve majör komplikasyon izlenmedi. Takip süresince hiçbir hastada teyp erozyonu saptanmadı. Sonuç: TVT, fasyal sling operasyonlarına göre daha kısa sürede yapılması, daha az kanamaya yol açması, hastanede kalış süresini kısaltması ve yüksek başarı oranı ile tercih sebebi olabilir.Objective: To compare the long term results of the Tension free Vaginal Tape (TVT) and fascial sling in treatment with stress urinary incontinence. Material and Methods: A total of 113 patients treated with Tension free vaginal tape (TVT) and fascial sling between May 2002 and July 2008 were included into the study. Complete dryness was accepted as success, 50% reduction in pad number was evaluated as partial success, and reduction less than 50% in number of pad was evaluated as failure. Statistical analysis was performed using SPSS®18.0 for Windows with the student t test for parametric variables, and the chi-square test for categorical variables. Statistical significance was considered at p<0.05. Results: Average of age was 52.94 (31-78), and follow-up periods for TVT and fascial sling were 44.3±8.7 months and 74.7±12.4 months, respectively. Mixed incontinence was present in 79.5% patients. Number of patients in menopause, type of incontinence, severity of incontinence, and age were similar in both groups (p>0.05). Success ratio was detected as 96% in TVT group and 77% in fascial sling group p<0.001. In TVT group bleeding, operation time and hospital stay were less than fascial sling group (p<0.05). In fascial group, obstruction and postvoiding residual urine were higher than TVT group (p<0.05). Bladder perforation was similar in both groups (p>0.05) and major complication was not detected in both groups. Tape erosion was not detected in follow-up period. Conclusion: TVT is superior to fascial sling with less operation time, less bleeding and short hospital stay, and preferable with high success rat

long term results of the tension free vaginal tape and fascial sling in treatment with stress urinary incontinence

Amaç: İdrar inontinans tedavisinde uygulanan fasyal sling ve transvaginal tape (TVT) operasyonlarının sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya Mayıs 2002- Temmuz 2008 tarihleri arasında inkontinansları fasyal sling ve TVT ile tedavi edilen 113 kadın hasta dahil edildi. Postoperatif ped kullanmama ve tam kuruluk hali başarı olarak kabul edildi. Ped sayısında %50 azalma kısmi başarı, ped sayısında %50’den az azalma başarısızlık olarak kabul edildi. İstatistiksel analizde student t test ve ki-kare testi kullanıldı ve SPSS®18.0 paket programı ile yapıldı. p<0.05 istatistiksel olarak anlamlı olarak kabul edildi. Bulgular: Yaş ortalaması 52.94 (31-78), takip süresi TVT için 44.3±8.7 ay, fasyal sling için ise 74.7±12.4 idi. Hastaların %79.5’inde mikst tip inkontinans mevcuttu. Her iki grupta hastaların inkontinans tipi, inkontinans şiddeti ve yaş dağı- lımları benzerdi (p>0.05). Başarı oranları TVT grubunda %96 ve fasyal sling grubunda %77 olarak saptandı (p<0.001). TVT yapılan hastalarda kanama daha az saptandı, operasyon süresinin ve hastanede kalış süresinin daha kısa saptandı ve bu bulgular istatistiksel olarak anlamlı idi (p<0.05). Obstruktif bulgular ve postmiksiyonel rezidüel idrar oranları fasyal sling grubunda daha fazla olarak saptandı (p<0.05). Her iki grupta da mesane perforasyon oranlarına birbirine yakın saptandı (p>0.005) ve majör komplikasyon izlenmedi. Takip süresince hiçbir hastada teyp erozyonu saptanmadı. Sonuç: TVT, fasyal sling operasyonlarına göre daha kısa sürede yapılması, daha az kanamaya yol açması, hastanede kalış süresini kısaltması ve yüksek başarı oranı ile tercih sebebi olabilir.Objective: To compare the long term results of the Tension free Vaginal Tape (TVT) and fascial sling in treatment with stress urinary incontinence. Material and Methods: A total of 113 patients treated with Tension free vaginal tape (TVT) and fascial sling between May 2002 and July 2008 were included into the study. Complete dryness was accepted as success, 50% reduction in pad number was evaluated as partial success, and reduction less than 50% in number of pad was evaluated as failure. Statistical analysis was performed using SPSS®18.0 for Windows with the student t test for parametric variables, and the chi-square test for categorical variables. Statistical significance was considered at p<0.05. Results: Average of age was 52.94 (31-78), and follow-up periods for TVT and fascial sling were 44.3±8.7 months and 74.7±12.4 months, respectively. Mixed incontinence was present in 79.5% patients. Number of patients in menopause, type of incontinence, severity of incontinence, and age were similar in both groups (p>0.05). Success ratio was detected as 96% in TVT group and 77% in fascial sling group p<0.001. In TVT group bleeding, operation time and hospital stay were less than fascial sling group (p<0.05). In fascial group, obstruction and postvoiding residual urine were higher than TVT group (p<0.05). Bladder perforation was similar in both groups (p>0.05) and major complication was not detected in both groups. Tape erosion was not detected in follow-up period. Conclusion: TVT is superior to fascial sling with less operation time, less bleeding and short hospital stay, and preferable with high success rat

Erkek ratlarda renal iskemi-reperfüzyon hasarına karşı elajik asitin koruyucu etkisi

The aim of this study was to evaluate the possible protective effect of ellagic acid (EA) on rats following renal ischemia–reperfusion (I/R) injury. Twenty-four Wistar rats were divided into three groups. Sham group underwent laparotomy then waited for 45 min without ischemia. I/R group were subjected to left renal ischemia for 45 minutes followed by 60 min of reperfusion. I/R+EA group were subjected to the same renal ischemia/reperfusion as the I/R group, were also given 85 mg/kg EA perorally 30 min prior to the ischemia. Malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were determined on the blood samples and kidney tissues. Histopathological analyses were conducted on the kidney tissues. I/R damage significantly increased serum MDA levels in the I/R group when compared with Sham group. Serum TAC level was significantly lower in I/R group than I/R+EA group. A significantly increase on OSI levels and decrease on TAC levels was found in the kidneys in I/R group. In I/R + EA group, EA reversed the negative effects of I/R injury. EA pretreatment.Bu çalışmanın amacı ratlarda renal iskemi-reperfüzyon (I/R) hasarına karşı elajik asitin (EA) olası koruyucu etkisini değerlendirmektir. Yirmi dört erkek Wistar rat; Sham, I/R ve I/R+EA olmak üzere üç gruba ayrıldı. Sham grubuna laparotomi yapıldı ve iskemi uygulanmaksızın 45 dakika bekletildi. I/R grubuna 45 dakikalık sol renal iskemiyi takiben 60 dakikalık reperfüzyon uygulandı. I/R+EA grubuna da I/R grubundakilere benzer şekilde iskemi/reperfüzyon prosedürü uygulandı, fakat iskemiden 30 dakika önce ratlara 85 mg/kg EA ağızdan verildi. Kanda ve böbrek dokusunda malondialdehit (MDA), total antioksidan kapasite (TAC), total oksidan statusu (TOS) ve oksidatif stres indeksi (OSI) bakıldı. Böbrek dokusu histopatolojik yönden incelendi. Sham grubu ile kıyaslandığında I/R grubunda serum MDA düzeyi anlamlı derecede yüksek idi. Ayrıca I/R+EA grubu ile kıyaslandığında I/R grubunda serum TAC düzeyi anlamlı derecede düşük bulundu. I/R grubunda böbrek dokusunda OSI düzeyi yüksek TAC düzeyi düşük bulunurken, I/R+EA grubunda iskemi ile oluşan etkilerin EA ile düzeldiği görüldü. EA verilmesinin tubuler nekroz skorunu azaltmada etkili olduğu bulundu. Çalışmanın sonucuna göre; EA, renal I/R hasarı sonrası meydana gelen oksidatif hasarı ve oluşan histopatolojik değişiklikleri iyileştirmektedir

The results of transrectal prostate biopsy in patients with low levels of prostate specific antigen

Objectives: The aim of this study is to evaluate the resultsof prostate biopsy of patients who had the prostatespecificantigen (PSA) levels below 4 ng/ml.Material and methods: The medical records of 63 patientswho underwent transrectal prostate biopsy, betweenJanuary 2005 and December 2011, due to suspicionof prostate cancer with the PSA levels under 4 ng/mlwere retrospectively reviewed.Results: Transrectal Prostate biopsy was performed to63 patients. Prostate cancer was detected in 12 (19%)patients. The mean value of PSA was 2.5 ng/ml. TheGleason score of Prostate cancer patients was 6,8 (5-7)and the number of positive cores were 3.Conclusions: The rate of prostate cancer was found as19% in patients with levels of PSA under 4 ng/ml and thisratio is compatible with the results of previous reports

Our laparoscopic radical nephrectomy experiences

Objective: In this study our aim is to present outcomes of laparoscopic radical nephrectomy (LRN) we have been applying for the management of renal masses. Methods: We retrospectively examined medical files of 54 cases who underwent LRN in the Urology Clinics of Dicle University between October 2010, and April 2014. Archival files of the patients were retrospectively analyzed as for age, gender, obesity, dimensions, and laterality of renal mass, smoking status, history of hypertension, histopathology results, blood transfusion (if any), hospital stays, peri- and post-operative complications, drain removal times, and method of removal of the nephrectomy material. Results: Our study population (n=54) consisted of 21 male, and 33 female patients with a mean age of 58,8 (29-82) years. Some of them were smoker (n=23), hypertensive (n=15), and obese (n=32) patients. Renal masses with a median diameter of 6.2 cm (4,5-16,5) were localized in the right (n=23) or left (n=31) kidneys. In all cases, transperitoneal approach was preferred. In 3 cases we have to switch to an open surgery. In 8 patients, blood transfusions were required. In 18 patients 4th port was used for the retraction of the liver, while in other cases only 3 ports were used. Median operative time was 115.6 min (75-192). Median hospital stay was 3,9 days (3-16). In one case abundant bleeding occurred because of splenic artery injury. Conclusion: Transperitoneal LRN is a minimally invasive surgical method which can be performed rapidly, and effectively. We think that in procedures performed in compliance with surgical principles, LRN can be realized safely with lower complication rates even by urologists in their initial experiences

The all-seeing needle instead of the veress needle in pediatric urologic laparoscopy

WOS: 000326970200011PubMed ID: 23560687Purpose: To investigate the feasibility of the all-seeing needle for safe entry and creation of pneumoperitoneum in pediatric urologic laparoscopy. Patients and Methods: A total of 14 children underwent various transperitoneal urologic laparoscopic procedures. The all-seeing needle, which is 4.85F in diameter, was used for safe entry into the abdominal cavity at the site of the umblicus in all cases. The microoptic was integrated with the light system and connected via a zoom ocular enabling direct visualization of the layers between the skin and the peritoneal cavity. Once the intraperitoneal access was obtained, CO2 pneumoperitoneum was created from one port of the three-way connector attached to the proximal part of the needle. Then the laparoscopic trocars were placed under vision of the microoptical system. Results: Mean age of the children was 4.52.9 years. In all children, the all-seeing needle was safely introduced into the abdominal cavity under direct vision. Then, CO2 pneumoperitoneum was succesfully performed. The mean time for optical puncture was calculated as 1.1 +/- 0.8 minutes. No complication was encountered during the introduction of the needle, creation of the pneumoperitoneum, and placement of the trocars. Conclusions: The all-seeing needle appears to be beneficial in safe entry and for creating pneumoperitoneum in laparoscopic pediatric urology cases. It eliminates the disadvantages of the Veress needle, which is blunt insertion, and may possibly prevent complications

Association of microRNA-related gene polymorphisms and idiopathic azoospermia in a south-east Turkey population

MicroRNAs (miRNAs) are small conserved non-coding RNA molecules that post-transcriptionally regulate gene expression. Although it is reported in many studies that there are associations between alterations of miRNA homeostasis and pathological conditions such as cancer, psychiatric and neurological diseases, cardiovascular disease and autoimmune disease, the effects of common genetic variants of these genes on male infertility are unclear. To better understand this effect, we performed a case-control study including a total of 108 infertile men with idiopathic azoospermia and 125 fertile control subjects. Real-time polymerase chain reaction was used to genotype six single-nucleotide polymorphisms (SNPs) of microRNA biogenesis pathway genes and the associations between individual and combined genotypes and idiopathic azoospermia were analysed. The results showed significant difference between the individual AA genotype frequency of the GEMIN3 (rs197388) gene in the patient and control groups, indicating that the AA genotype may be considered as indicative of a higher predisposition to idiopathic azoospermia. The combined genotype analysis, including six SNPs, revealed statistically significant differences between the patients and control subjects for some combinations. For example, the frequency of genotype distributions of the AA\CA-CC-TT-AT genotype combination for the XPO5-RAN-DICER1-GEMIN3 combined loci was significantly different, and it may be considered a predisposition to idiopathic azoospermia. According to the obtained results, both individual and combined genotypes of SNPs from miRNA genes may be used to predict the risk of male infertility with idiopathic azoospermia